The Second School of Clinical Medicine, Hangzhou Normal University Hangzhou, Zhejiang, China.
The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
Dig Dis Sci. 2024 Dec;69(12):4416-4429. doi: 10.1007/s10620-024-08699-w. Epub 2024 Nov 4.
Heterotopic gastric mucosa in the upper esophagus (HGMUE) is considered to be accompanied by pharyngolaryngeal symptoms, whereas the association strength between HGMUE and pharyngolaryngeal symptoms remains controversial. This study assessed the strength of the association between HGMUE and pharyngolaryngeal symptoms using a meta-analytic approach.
PubMed, Embase, Web of Science, and CNKI databases were searched for relevant articles published between January 2010 and January 2024. The pharyngolaryngeal symptoms of chronic cough, dysphagia, hoarseness, and globus in patients with HGMUE were summarized. The pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using a random-effects model. The exploratory analyses were also performed, including sensitivity and subgroup analyses.
A total of 17 observational studies (1 cohort study and 16 cross-sectional studies) with 626,369 patients (2414 HGMUE patients and 623,955 non-HGMUE patients) were included in the meta-analysis. HGMUE was significantly associated with an elevated incidence of chronic cough (OR: 3.36; 95% CI 1.25-9.01; P = 0.02), dysphagia (OR: 1.58; 95% CI 1.12-2.25; P = 0.01), hoarseness (OR: 4.13; 95% CI 1.47-11.56; P = 0.007), and globus (OR: 2.41; 95% CI: 1.43-4.04, P < 0.001). The association between HGMUE and the risk of dysphagia was found to be potentially influenced by study design, sample size, country, and diagnostic method, whereas the association between HGMUE with the risk of globus was potentially affected by the study design and country.
HGMUE was significantly associated with chronic cough, dysphagia, hoarseness, and globus. HGMUE should be taken into consideration for patients with pharyngolaryngeal symptoms.
食管上段异位胃黏膜（HGMUE）被认为与咽喉症状有关，但 HGMUE 与咽喉症状之间的关联强度仍存在争议。本研究采用荟萃分析方法评估 HGMUE 与咽喉症状之间的关联强度。
检索 2010 年 1 月至 2024 年 1 月期间发表的相关文献，包括 PubMed、Embase、Web of Science 和中国知网（CNKI）数据库。总结 HGMUE 患者慢性咳嗽、吞咽困难、声音嘶哑和咽部异物感的咽喉症状。采用随机效应模型计算汇总比值比（OR）和 95%置信区间（CI）。还进行了敏感性和亚组分析等探索性分析。
共有 17 项观察性研究（1 项队列研究和 16 项横断面研究）纳入 626369 例患者（2414 例 HGMUE 患者和 623955 例非 HGMUE 患者）进行荟萃分析。HGMUE 与慢性咳嗽（OR：3.36；95%CI 1.25-9.01；P=0.02）、吞咽困难（OR：1.58；95%CI 1.12-2.25；P=0.01）、声音嘶哑（OR：4.13；95%CI 1.47-11.56；P=0.007）和咽部异物感（OR：2.41；95%CI：1.43-4.04，P<0.001）的发生率升高显著相关。HGMUE 与吞咽困难风险之间的关联可能受到研究设计、样本量、国家和诊断方法的影响，而 HGMUE 与咽部异物感风险之间的关联可能受到研究设计和国家的影响。
HGMUE 与慢性咳嗽、吞咽困难、声音嘶哑和咽部异物感显著相关。对于有咽喉症状的患者，应考虑 HGMUE。
